AGES:
children ages 5-12, younger children are welcome to attend with a parent or guardian

TIME:

Friday & Saturday, 7-9 pm nightly

Sunday at 10 am

at Living Way Church

5295 Hwy 155 North in Stockbridge

770-474-5595

www.livingwaykids.com

REGISTRATION

Child's Information

* First Name

* Last Name

* Sex

* Age as of August 2010

* Grade Level for the 2010-2011 School Year

* Allergies and/or Medical Alerts

* First Name

* Last Name

* Address 1

Address 2

* City

* State

* Zip

* Home Phone

* Emergency Phone Where You Can Be Reached During the Program

* Email Address

* First & Last Names of Adults Authorized to Pick-up your Child

* Indicates Response Required